Jolly S L, Ferlic D C, Clayton M L, Dennis D A, Stringer E A
Littleton Orthopaedic Associates, Colo.
J Hand Surg Am. 1992 Jan;17(1):142-9. doi: 10.1016/0363-5023(92)90130-h.
Twenty-three Swanson silicone rubber implants in patients with stage III or stage IV rheumatoid arthritis were reviewed at an average of 72 months after surgery. Minimum follow-up in patients with unrevised implants was 44 months. Results were rated good or excellent in 48%, fair in 4%, and poor in 48%. Pain was the primary indication for surgery. Patient satisfaction and pain relief were achieved in 63%. Implant fracture occurred in 52%. Revision rate was 30%, including one recommended revision. Radiographic changes consistent with particulate synovitis were seen in 30%. Prosthesis settling and bony resorption were seen in more than 75% of the patients. Survivorship analysis demonstrated 42% survival at 77 months. Progressive clinical and radiologic deterioration was seen. Swanson silicone rubber implant is recommended only in the very low demand patient with stage III or stage IV rheumatoid arthritis and in those with insufficient bone stock to allow total wrist arthroplasty with a metal-on-plastic design.
对23例患有III期或IV期类风湿性关节炎的患者所植入的斯旺森硅橡胶假体进行了回顾，平均随访时间为术后72个月。未翻修假体患者的最短随访时间为44个月。结果评定为良好或优秀的占48%，一般的占4%，差的占48%。疼痛是手术的主要指征。63%的患者实现了患者满意度和疼痛缓解。假体骨折发生率为52%。翻修率为30%，其中1例为建议翻修。30%的患者出现了与颗粒性滑膜炎一致的影像学改变。超过75%的患者出现了假体下沉和骨质吸收。生存分析显示，77个月时的生存率为42%。出现了进行性的临床和影像学恶化。斯旺森硅橡胶假体仅推荐用于对功能需求极低的III期或IV期类风湿性关节炎患者，以及骨量不足无法进行金属对塑料设计的全腕关节置换术的患者。
